Health Professions Education Research Articles

Integrating virtual patients into undergraduate health professions curricula: a framework synthesis of stakeholders’ opinions based on a systematic literature review

BackgroundVirtual patients (VPs) are widely used in health professions education. When they are well integrated into curricula, they are considered to be more effective than loosely coupled add-ons. However, it is unclear what constitutes their successful integration. The aim of this study was to identify and synthesise the themes found in the literature that stakeholders perceive as important for successful implementation of VPs in curricula.MethodsWe searched five databases from 2000 to September 25, 2023. We included qualitative, quantitative, mixed-methods and descriptive case studies that defined, identified, explored, or evaluated a set of factors that, in the perception of students, teachers, course directors and researchers, were crucial for VP implementation. We excluded effectiveness studies that did not consider implementation characteristics, and studies that focused on VP design factors. We included English-language full-text reports and excluded conference abstracts, short opinion papers and editorials. Synthesis of results was performed using the framework synthesis method with Kern’s six-step model as the initial framework. We appraised the quality of the studies using the QuADS tool.ResultsOur search yielded a total of 4808 items, from which 21 studies met the inclusion criteria. We identified 14 themes that formed an integration framework. The themes were: goal in the curriculum; phase of the curriculum when to implement VPs; effective use of resources; VP alignment with curricular learning objectives; prioritisation of use; relation to other learning modalities; learning activities around VPs; time allocation; group setting; presence mode; VPs orientation for students and faculty; technical infrastructure; quality assurance, maintenance, and sustainability; assessment of VP learning outcomes and learning analytics. We investigated the occurrence of themes across studies to demonstrate the relevance of the framework. The quality of the studies did not influence the coverage of the themes.ConclusionsThe resulting framework can be used to structure plans and discussions around implementation of VPs in curricula. It has already been used to organise the curriculum implementation guidelines of a European project. We expect it will direct further research to deepen our knowledge on individual integration themes.

A qualitative exploration of transitions, compliance, and onboarding challenges for international students in health professional education degrees

Background: Australia provides education services to international students which includes international students completing a health professional education (HPE) degree. Studying for a HPE degree can be challenging for most students. There are specific challenges for international students when completing a degree with clinical placements. The challenges international students can face include receiving adequate and timely information, understanding health service access, and receiving the correct information from education providers and agents. Objectives: To gain an in-depth understanding of the challenges for international health professional education students in accessing healthcare, understanding the requirements of compliance to attend clinical placements and the difficulties with attending clinical placements. Design: A semi-structured interview schedule based on findings from a survey (N = 318 participants) was used to explore international student perspectives in one-on-one interviews. Methods: Data were collected from international HPE students from a single Australian metropolitan multi-campus university using a questionnaire, which included qualitative open-ended questions, in addition to semi-structured follow-on interviews. Data collection took place between March and October 2021 and qualitative data were inductively thematically analysed. Results: Challenges reported in interviews by six international students were focused on understanding the navigation of new administrative systems and compliance processes. Students noted gaps in the communication of understanding legislative compliance requirements to attend clinical placements, difficulties accessing healthcare and making use of overseas student health cover, organisational issues, and transport issues when attending clinical placements. Conclusions: Higher education providers and international education agents must address communication deficits in course requirements linked to clinical placement prerequisites. This study highlights gaps in commencing international students’ understanding, and higher education providers' communication of clear, timely detailed information.

Mapping Evidence in Teaching Palliative Care in Undergraduate Curriculum of Healthcare Professionals Qualification: A Systematic Scoping Review Protocol.

Clinical Practice Guidelines recommend interprofessional collaboration in palliative care. However, healthcare profession educators lack clear curricular guidance, particularly for undergraduate programs, to adequately train future professionals for effective participation in such teams. This systematic scoping review protocol aims to address this gap by: (i) mapping evidence on key characteristics of teaching palliative and end-of-life (EOL) care to undergraduate healthcare and social care students, and (ii) identifying the nature and effectiveness of educational interventions for improving palliative care education in the undergraduate curriculum. The protocol adheres to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocol Extension for Scoping Reviews (PRISMA-P-ScR) guidelines, while the proposed systematic scoping review study will be conducted based on methods and steps identified by Arksey and O'Malley and experts in the field. We will conduct systematic searches across five EBSCOhost databases using relevant search terms. Additionally, a limited grey literature search will be conducted on the first 100 results of Google Scholar and Open-Grey. The selection process will follow PRISMA-Extension for Scoping Reviews. Two independent reviewers will screen titles and abstracts for eligibility. Data extraction will be done on standardized forms in duplicate with cross-checking by a third reviewer. Braun and Clarke's thematic analysis approach, combining thematic and directed content analysis, will be employed for analysis. Intervention effectiveness will be narratively summarized based on the TIDieR checklist. Meta-analysis will be considered if applicable and data is homogeneous. Palliative care education (PCE) is a crucial element of undergraduate health professions education. This study's findings may aid educators in fostering optimal learning among healthcare students, who can then positively influence community health outcomes. The protocol was submitted for ethical clearance to the University of KwaZulu-Natal's Biomedical Research Ethics Committee and granted exemption from ethics review (00024289). We will disseminate findings through scientific journal publication and by sharing a summary with relevant institutions and attendees at health promotion and interprofessional education conferences.

The state of Continuing Professional Development in East and Southeast Asia among the medical practitioners

Introduction: Continuing medical education and continuing professional development activities (CME/CPD) improve the practice of medical practitioners and allowing them to deliver quality clinical care. However, the systems that oversee CME/CPD as well as the processes around design, delivery, and accreditation vary widely across countries. This study explores the state of CME/CPD in the East and South East Asian region from the perspective of medical practitioners, and makes recommendations for improvement. Methods: A multi-centre study was conducted across five institutions in Hong Kong, Indonesia, Malaysia, Singapore and Taiwan. The study instrument was a 28-item (27 five-point Likert scale and 1 open-ended items) validated questionnaire that focused on perceptions of the current content, processes and gaps in CME/CPD and further contextualised by educational experts from each participating site. Descriptive analysis was undertaken for quantitative data while the data from open-ended item was categorised into similar categories. Results: A total of 867 medical practitioners participated in the study. For perceptions on current CME/CPD programme, 75.34% to 88.00% of respondents agreed that CME/CPD increased their skills and competence in providing quality clinical care. For the domain on pharmaceutical industry-supported CME/CPD, the issue of commercial influence was apparent with only 30.24%-56.92% of respondents believing that the CME/CPD in their institution was free from commercial bias. Key areas for improvement for future CME/CPD included 1) content and mode of delivery, 2) independence and funding, 3) administration, 4) location and accessibility and 5) policy and collaboration. Conclusion: Accessible, practice-relevant content using diverse learning modalities offered by unbiased content providers and subject to transparent and rigorous accreditation processes with minimal administrative hassle are the main considerations for CME/CPD participants. Keywords: Medical Education, Health Profession Education, Continuing Professional Development, Continuing Medical Education, Accreditation

Education in focus: Significant improvements in student learning and satisfaction with ophthalmology teaching delivered using a blended learning approach.

This study aimed to measure student satisfaction with a revised ophthalmology delivery format, which due to the pandemic had previously relied on a remote online flipped classroom (OFC) format compared to a blended learning format. This educational strategy combined online learning with in-person seminars and practical patient centred sessions. Our previous investigations demonstrated a significant lack of student satisfaction with a curriculum solely reliant on a remote OFC, as such we hypothesised that a blended learning approach would result in improved levels of student satisfaction and knowledge gain. Non-randomised intervention study of two groups; group 1 = OFC group and group 2 = BL group, compared perspectives of 4th year ophthalmology students using a validated course evaluation questionnaire (CEQ). A total of 59 students from the BL group (n = 257; response rate = 23.0%) and 28 from the OFC group agreed to participate in the study (n = 114; response rate = 24.6%). Participants in the BL group felt it was easier to determine the standard of work that was expected (77.42% v 60.71%) and demonstrated significantly increased satisfaction with staff motivation of students (95.16% v 64.29%, p <0.001) and provision of feedback (74.19% v 46.43%, p = 0.004), compared to the OFC group. Furthermore, students in the BL group also felt the course significantly improved their analytical skills (64.52% v 42.85%, p = 0.023) and ability to work as part of team (69.36% v 25%, p <0.001) as well as reporting reduced dissatisfaction with the level of choice afforded in terms of how they would learn (33.88% v 60.71%, p = 0.31) and the how they were assessed (59.68% v 89.28%, p = 0.004). No evidence of a statistical difference in exam score was observed. The COVID-19 pandemic necessitated an unavoidable pivot to online and distance learning, to meet the challenges presented by government mandates and social distancing requirements. Since many of these directives have been reversed, it is important to evaluate the effectiveness and learner perceptions' of the online and distance learning interventions. In this study we demonstrated a significant student preference for BL compared to the OFC approach, with comparable student performances determined by MCQ examinations. Our findings suggest a preference for reintroducing in-person and patient engagement activities in post-pandemic health professions education.

AI Applications in Pediatrics: Past, Present, and Future

In pediatric medicine, Artificial Intelligence (AI) currently remains as a novel area for research and development. Most AI applications created for adults are often complicated to fully transfer over to pediatrics due to several limiting factors. These factors include physiological differences, lack of data, and unknown implications. Nevertheless, applications in adult medicine have influenced extensive reviews for algorithms that show significant potential in pediatrics. As pediatric data gradually increases, several AI algorithms for adults can be fine-tuned to provide similar accuracies and sensitivities for diagnosing specific pediatric diseases. This chapter will discuss the pioneering applications of AI in medicine as well as current and arising applications or subspecialties. Areas of discussion encompass precision medicine, oncology, cardiology, radiology, chatbots, neurology, and ophthalmology. AI algorithms within these domains range from assistance with diagnoses, shorter waiting times, to continuous monitoring. Common benefits exhibited by many applications include increased accuracy, time and cost efficiency, patient compliance, and flexibility. For example, medical wearable technology and chatbots are two AI applications that can provide certain patient care in both outpatient and inpatient settings. These algorithms are convenient to use and offer continuous monitoring when a provider may not be readily available. Furthermore, other topics explored in this chapter relate to common concerns for using AI in pediatric medicine and education for health professionals, parents, and children. Most apprehension pertains to the misuse of data and quality of care. Reviewing these concerns is crucial for AI to exponentially flourish in medicine. Without established comprehension, hesitance and distrust may prevail over the promising potential AI can offer. Education and training can help alleviate these common misunderstandings by explaining how AI can affect both medicine and health care. Moreover, learning environments can allow health professionals, parents, and children to openly communicate their concerns that could guide ethical frameworks for developing AI applications. Analyzing these past, present, future applications, and related concerns can help demonstrate how AI will transform pediatric medicine.

Assessment in Health Professions Education

Assessment in Health Professions Education

Training Workshop on Teaching/Learning in Health Professions Education for Medical Teachers: Feedback of the Participants

Background: For enhancing teaching skills of faculty members, 3-day Training Workshop on Teaching/Learning in Health Profession Education was organized at Bilwal Medical College Liaquat University of Medical and Health Sciences Jamshoro Sindh Pakistan. Main objective of the study was to assess feedback of the participants at New World Kirkpatrick’s Model level 1 and 2. Methods: This was cross-sectional study conducted using self-administered questionnaire. The questionnaire had 5-parts; 1) Demographics; 2) Rating of participants on attributes of training workshop at scale 1-10 (1=poor, 10=excellent); 3) Confidence level of the participants on skills learned in specific session at Likert scale 1-4 (1=Not-confident, 4=Extremely-Confident) on retro-pre-questionnaire; 4) Open-ended questions on strengths of workshop and 5) areas for improvement. The data was analyzed for central tendency. The data of retro-pre-questionnaire was normally distributed, so, t-test used for comparison of means. Data of open-ended questions was sorted manually. Results: The rating on attributes of training workshop i.e. usefulness (8.59±1.18), content (8.53±1.12), relevance (8.59±1.23) and facilitation (9.18±0.95) was notable and overall (8.82±0.95) too. The perceived confidence level of participants was significantly (&lt; 0.001) enhanced on five Skills Learned in Specific Sessions of Training Workshop: developing learning objectives (before 2.24±0.44, after 3.29±0.47 ); developing effective PowerPoint presentation (before 2.59±0.51, after 3.06±0.56), conducting large group teaching (before 2.53±0.72, after 3.12±0.60), developing lesson plan for teaching (before 2.12±0.60, after 3.18±0.64), and conducting small group teaching (before 2.76±0.75, after 3.41±0.51) Conclusion: Overall reaction of the participants was constructive and their confidence level was significantly enhanced on specific skills related to teaching/learning.

Challenges for Sustainable Interprofessional Education in South Korea: Insights from Key Global Countries

Interprofessional education (IPE) is relatively new in medical schools in South Korea. Since the introduction of IPE in 2022, its effective and sustainable implementation has been of great interest in medical schools. This study analyzed literature on the development of IPE in the United States, Canada, the United Kingdom, Australia, and Japan to explore strategies for successful IPE in Korean medical schools. A systematic literature search focused on institutionalizing IPE yielded 30 papers for review. The findings included the following crucial elements for effective IPE: (1) government or institutional-led support; (2) establishment of networks and partnerships; (3) development of standardized core competency frameworks for IPE; and (4) inclusion of IPE in accreditation standards. These aspects underscore the importance of IPE as an essential component of health professional education that should be effectively and sustainably implemented in academic settings. The study concludes that the successful integration and sustainable development of IPE in Korean health education will necessitate expanded and proactive governmental support. Moreover, promoting collaborations among universities, hospitals, and local healthcare institutions will be vital for creating synergies in implementing IPE programs. Establishing networks to develop and execute joint IPE initiatives and securing initial support for conceptualizing and developing competency frameworks will be critical. Additionally, forming consortia of healthcare accreditation bodies to collaboratively develop and incorporate IPE standards into evaluation criteria will be essential. Efforts to surmount these challenges will contribute to building a structural and institutional support system for the successful introduction and sustainability of IPE in Korea.

Artificial Intelligence in Health Professions Education

Artificial Intelligence in Health Professions Education

Learning, teaching and assessment in health professional education and scholarship in the next 50 years

This paper explores how health professional education and scholarship is likely to evolve over the next 50 years. Recognising the ambitious nature of this goal, we have adopted an approach of “looking back to predict the future”, drawing on past trends and lessons learnt to offer some predictions and recommendations. In doing so, we are mindful that recent advances in technology, especially related to generative artificial intelligence (AI), have added a further layer of complexity. The rapid rate of maturation of these technologies and the accompanying array of AI-based software solutions suggest that the educational landscape is likely to change dramatically—and continuously—over the foreseeable future. Within this context, it may seem premature to predict the future or make recommendations. However, in this paper we argue that urgent action is needed by educators to engage with the evolving landscape and to proactively develop models to harness the full potential of emerging technologies. Six themes are addressed, including: 1) the evolving role of educators and education providers, 2) innovative educational models and ethical frameworks, 3) future-focused competencies, 4) authentic assessment, 5) interprofessional education and 6) educational scholarship. This paper proposes a set of recommendations with the intention of stimulating critical discourse that can potentially lead to ongoing exploration of relevant issues.

Education and training programs for health professionals' competence in virtual consultations: a scoping review protocol.

Digital solutions, telemedicine, and technologies are increasingly becoming a part of the health system, requiring current and future health professionals to master skills in these domains. The objective of this scoping review is to explore, report, and map the evidence on education and training programs for current and future health professionals' competence in virtual consultations. This review will consider any studies on education and training programs designed to optimize current and future health professionals' competence in virtual consultations in any setting, such as faculties, universities, university colleges, hospitals, or community locations. This review will be guided by the JBI methodology for scoping reviews. Published and unpublished sources of information will be searched for in MEDLINE (PubMed), CINAHL Complete (EBSCOhost), and Scopus. Studies written in English, German, Danish, Swedish, and Norwegian will be considered, with no geographical or cultural limitations. Two independent reviewers will screen retrieved papers, and a standardized tool will be used to extract data from each included source. The results of the extracted data will be presented in tabular format, together with a narrative summary of the evidence. https://doi.org/10.17605/OSF.IO/BSMUY.

The four-dimensional curriculum framework: 10 years on

The Four-Dimensional Curriculum Framework (4DF) was first published in Focus on Health Professional Education in 2013. It was created in response to a gap in the literature for a curriculum development tool for interprofessional health that could navigate the challenges associated with conceptualising shared educational opportunities across siloed health professional programs. Its four interconnecting dimensions emphasise the dynamic interplay between curricular elements, highlighting the fact that curriculum design is rarely linear. As a theoretical curriculum framing tool, it facilitates the articulation of big picture considerations when designing learning and teaching activities. Since 2013, it has been cited 60 times by researchers and educators across the globe, indicating that it has been used largely as it was originally intended—to interrogate the purpose and effectiveness of a curriculum in broad terms. This paper revisits the features of the 4DF and, in the light of its application in the literature, explores opportunities to expand its functionality from a theoretical framing tool to one that also provides a practical application of the framework.

Developing your philosophical stance as a PhD student: A case study

Developing your philosophical stance can be daunting for new PhD candidates in health professional education. Contemplating the diversity of worldviews in the social sciences may be confronting for those of us from a biomedical background who are unfamiliar with the concepts and unused to metaphysical reflection. However, we need to explore the literature and reflect on our own underlying beliefs to maintain the cohesion of our research. Philosophical stance is generally taken to mean ontology and epistemology, or “what is real” and “how we know what we know”, so developing your philosophical stance involves clarifying your beliefs about the nature of reality and knowledge. Our philosophical stance will influence our research design, practice and reporting. If we are unaware or uncertain of our philosophical stance, we risk misalignment, which will detract from our research claims and undermine their impact. Our philosophical stance is, thus, crucial for ourselves and our audience. This article presents a case study of how my philosophical stance developed over my candidature. I share it to provide insights for others contemplating the same journey. In particular, this paper acknowledges and normalises how understanding and articulating that stance evolved over time.

“It would have been more constructive if she had given me points to improve on”: Student perceptions of patient feedback in dietetics

Introduction: The voice of the patient has historically been peripheral in many health professional programs. Methods: We investigated the merit of health professional students seeking patient feedback on the effectiveness of their clinical consultations as part of usual clinical placements. Dietetic students (n = 34) formally sought patient feedback after usual consultations (n = 48) then completed a reflective feedback tool. The experience of seeking and receiving patient feedback was then explored through student written narratives, facilitated with a focus group (n = 4). The student reflective forms, and recorded and transcribed focus group, were inductively analysed for themes. Results: Despite the positive perception of the educational task, students did not value the overwhelmingly positive feedback they received from patients, preferring more critical clinical educator feedback. Conclusion: The lack of value attributed to patient perspectives in the learning process raises questions about the success of the current teaching of patient-centred care despite the aspiration to legitimise the patient voice as central to health professional education.

Addressing the Sleep Deprivation Epidemic in Adolescents: Findings from the Youth Risk Behavior Survey 2021

ABSTRACT Background Millions of U.S. youths do not get adequate sleep. Healthy People 2030 has prioritized sleep and identified an objective to increase the proportion of students in grades 9 through 12 who get sufficient sleep. Purpose This study investigated the predictors of severe sleep deprivation in adolescents. Methods Data were obtained from the 2021 Youth Risk Behavior Survey (YRBS), a school-based survey, conducted by the Centers for Disease Control (CDC). Severe sleep deprivation was defined as 6 hours or less sleep per night on school nights. Binary logistic regressions were used to estimate the associations. Results Among the 17,232 youth surveyed, 48.2% experienced severe sleep deprivation. Self reported overweight and poor mental health status, limited physical activity, excessive screen time, smoking/vaping, lacking school connectedness, parental monitoring, school, and neighborhood safety as well as not having stable housing were statistically significant predictors of adolescents’ severe sleep deprivation. Discussion Scaling up sleep health programs in schools, neighborhoods, and subpopulations of adolescents could be a fundamental step toward achieving health equity. Translation to Health Education Practice Educators, health professionals, and social workers should be informed about the risk and protective factors of sleep health, and adolescents’ vulnerabilities to sleep deprivation.

Importance of Understanding Minority-Serving Institutional Designations and Associated Abbreviations in Contemporary US Higher Education

Prefixes and suffixes in pharmacy might suggest a drug class, generation, or mechanism of action. As pharmacy educators, we also use an alphabet soup of acronyms and abbreviations to describe board certifications or professional organizations and our affiliation to them. Although we may be experts in nomenclature and abbreviations related to health professions education, sometimes, we also have to remind ourselves to be humble and embrace a learning mindset relative to the abbreviations and naming conventions used more broadly in higher education and in other fields. This article discusses the use of abbreviations in minority-serving institutions as well as the financial, historical, and political implications surrounding their names and definitions. The need to appreciate institutional designations and what they represent is not unique to minority-serving institutions or solely the responsibility of personnel who lead diversity, equity, inclusion, and accessibility efforts. Appreciating what institution designations mean is a logical first step toward discovering and acting upon the possibilities to facilitate and support the success of all learners recruited into the pharmacy profession.

Verbatim theatre as a creative approach to health professions education research translation.

Traditionally, the impact and outcomes from health professions education research (HPER) have focused on academic outputs, whereas in the humanities, research translation is conceptualised more broadly and creatively, including research-based performances like verbatim theatre. Translating HPER findings through the emotive and embodied nature of a verbatim theatre performance provides a unique opportunity to translate research data and create alternative learning spaces for rich and valuable insights that aligns with transformative pedagogy. In this paper, we describe the background of verbatim theatre, a form of performance, which draws on a research participants' testimony and lived experience and how we used this creative approach to translate HPER findings. We discuss the experiential process of bringing an interdisciplinary team together, health professions academics and an academic playwright to craft a verbatim theatre script that provided space to honour the breadth, depth and diversity of participant voices from a large (n = 100) qualitative research study exploring professionalism and sociocultural factors in health professions education (HPE). Furthermore, we discuss the powerful potential of drawing on research-based performance to create alternative, safe and non-threatening learning spaces to resonate with and experience HPER in new and transformative ways. Finally, we offer reflexive insights on the key opportunities and challenges we encountered in translating HPER into a verbatim theatre performance. Verbatim theatre presents an innovative and creative way to communicate and translate HPER. This paper offers research and pedagogical insights in translating research into verbatim theatre to support transformative pedagogy and practice in HPE. In conclusion, we encourage other health professions researchers to consider this dynamic and creative approach to transforming HPE.

Eight ways to get a grip on validity as a social imperative.

Validity as a social imperative foregrounds the social consequences of assessment and highlights the importance of building quality into the assessment development and monitoring processes. Validity as a social imperative is informed by current assessment trends such as programmatic-, longitudinal-, and rater-based assessment, and is one of the conceptualizations of validity currently at play in the Health Professions Education (HPE) literature. This Black Ice is intended to help readers to get a grip on how to embed principles of validity as a social imperative in the development and quality monitoring of an assessment. This piece draws on a program of work investigating validity as a social imperative, key HPE literature, and data generated through stakeholder interviews. We describe eight ways to implement validation practices that align with validity as a social imperative.

Five ways to get a grip on applying a program evaluation model in health professions education academies

The proliferation of health professions educator academies across Canada and the United States illustrates the value they hold for faculty and institutions. Yet, establishing and evaluating the efficacy of them through program evaluation can be challenging. Moreover, academy leadership often lack the time, bandwidth skillset and personnel to undertake rigorous program evaluation efforts. We outline a step-by-step guide for getting a grip on evaluating health professions educator academies. Developing a plan for program evaluation in advance of any new academy initiative helps to ensure the academy calibrates and re-calibrates to accomplish outcomes and meet stakeholder expectations. It also provides a mechanism for tracking academy impact, which strengthens requests for funding, promotes sustainability and encourages continued buy-in and support from institutional stakeholders. For all of these reasons, we present the following recommendations: apply the relevant program evaluation framework(s); identify resources for program evaluation; prepare to tell your academy’s story; list desired program outcomes; establish a data collection plan; and obtain institutional review board approval.